Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NX0800X | Chiropractor Orthopedic Specialist | A76035 | CA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | N4521 | TX |
NPI | 1134142029 |
---|---|
Provider Name | Dr. Melanie Battle Kinchen |
First Address | Fort Worth, TX 76244-5412 |
Second Address | Fort Worth, TX 76244-5412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 05/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
214880101 | (05) | TX |
337959 | MEDICARE PTAN (01) | TX |
H15533 | (02) | |
H15533 | (02) | CA |